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MS, Fatigue and Sleep Apnea and What To Do

MS, sleep apnea and fatigue

Individuals who have multiple sclerosis (MS) are no stranger to fatigue, and the challenges this symptom places on the quality of life can be enormous. If you struggle with MS and fatigue, could sleep apnea be contributing to or causing it, and what can you do about it? The role of obstructive sleep apnea in fatigue in MS is not well understood and was the focus of a new study.

This study is not the first time the relationship between sleep apnea and MS with fatigue has been explored. In a 2012 study, for example, 62 people with MS and 32 healthy controls, all of whom had not been diagnosed with a sleep disorder before the study, underwent polysomnography and tests for sleepiness and fatigue.

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The authors discovered obstructive sleep apnea in 36 of the MSers and 15 of the controls. After the researchers made adjustments for several factors, they found that both severe fatigue and mental fatigue were associated with sleep apnea and respiratory problems during sleep in individuals with MS but not in controls.

Based on their findings, the investigators concluded that obstructive sleep apnea is frequently present in people with MS and that the sleep disorder is associated with fatigue. Although this may seem like a logical conclusion, especially for people with MS who suffer daily with fatigue and who know they have sleep apnea, researchers are still unclear about the contributions of obstructive sleep apnea to fatigue related to MS along with other clinical and sleep-related factors.

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New sleep apnea and MS study
Therefore, in this new study, which explored the relationships between the severity of fatigue, obstructive sleep apnea, risk of sleep apnea, and quality of sleep among MSers, a group of 195 MS patients participated. All the subjects completed questionnaires and scales regarding sleepiness, fatigue severity, insomnia, and daytime symptoms.

Based on test results, here’s what the researchers found:

  • 41 (21%) of the participants were found to have obstructive sleep apnea
  • 38 (93%) of those diagnosed with sleep apnea and 110 (56%) of all the participants had scores that indicated they had an elevated risk of developing obstructive sleep apnea
  • Analysis of the data indicated that the most significant predictors of more severe fatigue (on the Fatigue Severity Score test) were a greater number of nighttime symptoms, higher disability level, and higher scores on the STOP-Bang test (a short questionnaire used to screen for obstructive sleep apnea)

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What does all of this mean? The authors concluded that sleep apnea “may be highly prevalent yet underrecognized” as a contributor to fatigue in people who have MS.

Obstructive sleep apnea can be treated. If you have MS and fatigue and a sleep partner, ask him or her whether you snore or experience short episodes of stopped breathing during the night.

Symptoms of sleep apnea include waking up with a dry throat and mouth, excessive daytime sleepiness, loud snoring, and sometimes waking up with a gasping sensation. If your healthcare provider has not talked about or tested you for obstructive sleep apnea, it’s time for the discussion.

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Braley TJ et al. Obstructive sleep apnea and fatigue in patients with multiple sclerosis. Journal of Clinical Sleep Medicine 2014; 10(2): 155-62
Kaminska M et al. Obstructive sleep apnea is associated with fatigue in multiple sclerosis. Multiple Sclerosis 2012 Aug; 18(8): 1159-69
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